Provider Demographics
NPI:1558025577
Name:WILLIAMS, JUDITH KIMBALL (LMFT)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:KIMBALL
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 FARM RD
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94024-7020
Mailing Address - Country:US
Mailing Address - Phone:659-575-0363
Mailing Address - Fax:
Practice Address - Street 1:10 FARM RD
Practice Address - Street 2:
Practice Address - City:LOS ALTOS
Practice Address - State:CA
Practice Address - Zip Code:94024-7020
Practice Address - Country:US
Practice Address - Phone:659-575-0363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-26
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT34116106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist